diary of an emerging social enterprise

We have arrived!!! Yes, that is right, we just got a letter from the IRS that let us know that OperationOF is now exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code.

We are now a registered charity in the United States! This means we can accept tax-deducable donations (as well as bequests, devises, transfers or gifts). So we now a place where you can donate!

But we aren’t only looking for money. We know people are short on cash in these trying times, but you can still help.  Check out the donate page to see how you can help on the cheap.

We had a great deal of interest in Shannon’s posting about Jessica, the young fistula survivor who escaped the LRA. This video is a montage of pictures, music and audio of Jessica speaking about her ordeal. She specifically discusses a conversation she had with her father after the LRA abducted her. The soliders brought Jessica home and the exchange she describes with her father is quite moving. You def want to see this video with the sound on.

Thanks to Lauren Bucherie for the fantastic music supervision.

As Seth sprinted off to the surgical ward to accompany Dr. John Kelly in a complex fistula surgery our first day, I wandered into the post-op recovery ward hoping to make some friends and listen to some of the women’s stories. People say that Ugandans speak English, but that really means a select few educated Ugandans speak English fluently. When speaking to people from villages, you have nothing if you cannot communicate in Lugandan, Bantu, or Runyankore. Needless to say, I had nothing.

I slowly walked through the ward feeling like a self-conscious spectacle as most of the women unabashedly and curiously stared at my every movement. Young white women are not the usual in the Kitovu fistula ward. Smiling and trying pathetically to communicate through hand gestures and facial expressions, I felt like I was going to be the day’s main attraction. After about 15 minutes of inadvertently amusing the nurses, Mama Winnie, the head nurse and a fistula survivor, led me to a young girl from the North of Uganda who sat quietly reading the Bible on her bed. Mama Winne told me that this young lady was a very special patient I would be able to speak with her. Her name is not Jessica, but that’s what I’ll call her in order to hide her identity and protect her from the danger she escaped.

In perfect English, Jessica introduced herself and invited me to sit with her and play cards. I was immediately stunned by her ability to express herself, her confidence and her unwavering faith in everything she said and did. We passed the morning chatting Jessica even taught me to wear an African headscarf (resulting in my immediate celebrity status in the fistula ward). Jessica was from a very small village, but spoke English as well or better than many of the educated professionals we encountered along the way. I wondered how this twenty year old woman full of poise, who in any other life would be experiencing her first years of college, ended up in rural Masaka for a fistula repair? I soon learned the heart breaking answer when Jessica and I went for a walk on the hospital grounds. We stopped on a grassy knoll and I listened to her unimaginably tragic story. Her words left me with a confusing mix of admiration of her strength and complete disgust at the depth of humanity’s sadism.

As she painted my nails, Jessica told me about her village in the North of Uganda and how it has frequently experienced the brutal aggression of the Lord’s Resistance Army or LRA. For those of you not familiar, the LRA is an extreme rebel group claiming to bring a theocratic government based on the Ten Commandments and the Bible to Uganda. In order to implement their vision, the LRA regularly resorts to a variety of human rights abuses including rape, abduction and maiming of civilians, especially children. The LRA is led by an especially brutal megalomaniac named Joseph Kony. When Kony’s influence with the population began to wane, he set about abducting children from villages and indoctrinating them through unspeakable violence into his inhumane regime Kony uses children in his war because they are easy to manipulate, intensely loyal and are emotionally immature. Young boys effortlessly carry small automatic weapons that create mass carnage and young girls are forced, in many cases, to be sex slaves.

At fourteen, Jessica returned to her village on holiday from the school she attended in the South and one night was abducted from her home by the LRA. She was brought to Kony, who gave her as a ‘wife’ to one of the Commanders of the Army. She spent the next four years living in the bush. As she lifted her long skirt to show me the scars from the bullet wounds she endured while fleeing from the fighting, Jessica told me there were many girls who lived such a life. Girls who are taken from their families and lives, forced to cook, clean, care for and sleep with strange men. Girls forced to forget those who love them, run for their lives when fighting started, feel the bullets intended for soldiers, live the war that stole their innocence… Jessica eventually became pregnant at 18 and went into labor in the bush. But something went very wrong, and her baby died after days as she laboured in the bush, trying to push it out of her small malnourished body. As Jessica describes it, she died and God brought her back to life. Only, the life she was brought back to left her with an extremely severe vaginal and rectal fistula. Kony allowed her to seek treatment in a neighboring country and she made a bold decision to take that opportunity to flee – a choice that often ends in a brutal death.

I do not really have the words to describe how I felt when I listened to her story. I do not believe a string of sentences exists that can convey the suffering in her eyes or on her sweet youthful face, neither of which we can actually show you for the sake of Jessica’s safety. Nor can I describe the depth of her Faith and her profound belief in God’s plan for her.

When you read these stories, or others like them in newspapers or magazines, its easy to imagine a far-off place that almost feels fictional. But, these tragedies are real. They destroy lives, they abhor our senses and ultimately, they inspire our action.

Determined. That is the best word to describe John Kelly. I know, I know. If you look at my blog postings, at least 40% of them include a reference to or direct praise of John Kelly. Sorry, I cant help it. This guy is superhuman and the closest thing to “hero” I have had the pleasure of personally witnessing.

When Shannon and I returned from checking out of the hotel and into the home of a Kitovu-trained doctor, John was still seated exactly where I left him…3 hours earlier. He never, ever, ever gives up. “No hope? ahhh, there’s always hope.” I can still hear his voice echo as he faces down what other doctors would call a lost cause. You see, some surgeons don’t want to stain their success rate with a failed attempt on a hopeless case. John doesn’t actually know what that phrase, “hopeless case” means – he just can’t comprehend the absence of possibility. Even in the most desperate cases, where a woman has lost most of her soft tissue and retains only tatters of her excretory system, John will step up and give it a try if he thinks he can help her live a better life. Maybe not a perfect life, but an improved existence – maybe even a tolerable one. It is in these catastrophic circumstances that Kelly morphs into determination personified – the best, the only chance at a livable life for women no one else will help. So was the case when I found John sitting sweaty and undeterred, with a lap full of surgical tools and a confident focus beneath his half-tied mask. “Almost done,” he smiled.

After he finished up, John invited me for a tea in the break room. We chatted a short catch up over the warm brew and I lost John as he noticed the next patient roll past the open door. “Make sure you get enough to eat,” he demanded as he rushed out the door waving, “those doughnuts are good.”

I completely understood – John was off to save another life and there was no time to spare.

To get an idea of how local people travel and to understand the challenges of moving long distances by road transport, Shannon and I take public transport everywhere we travel. While certainly not the most comfortable mode of travel, public buses are undoubtedly the most educational.

By arriving in Masaka, we have now covered the following distance.

Total Distance: 1,724 miles (2,775 kilometers)
Total Transit Time: 74 hours

The light blue color indicates a road we traveled down twice.

View Larger Map

• Kigali, Rwanda to Masaka, Uganda - 200 miles by bus - 8 hours
• Goma, DRC to Kigali, Rwanda - 80 miles by bus - 4 hours
• Kigali, Rwanda to Goma, DRC - 80 miles by bus - 4 hours
• Butare, Rwanda to Kigali, Rwanda - 57 miles by bus - 2 hours
• Kigali, Rwanda to Butare, Rwanda - 57 miles by bus - 2 hours
• Kampala, Uganda to Kigali, Rwanda - 275 miles by bus - 9 hours
• Nairobi, Kenya to Kampala, Uganda - 375 miles by bus - 14 hours
• Mombasa, Kenya to Nairobi, Kenya - 300 miles by rail - 14 hours
• Nairobi, Kenya to Mombasa, Kenya - 300 miles by rail - 17 hours

In the DRC, internet connectivity was rarely available and my Rwandan phone didn’t work. So when I learned that the doctor at our next destination had a last minute schedule change, we had a bit of a problem. Given the communications difficulty, we decided to head back to Kigali to get our feet under us again.

After reviewing the options, we decided to pull our trip forward and go to Masaka, Uganda, to visit Dr. Maura Lynch at Kitovu hospital. I first heard about Kitovu at the April meetings in Accra, where I met Dr. Maura and she told me about the wonderful work she and her team were doing in Uganda. Kitovu is Uganda’s leading fistula hospital and was right in the middle of one of its four annual treatment camps. We were very excited to visit, but when we called Dr. Maura to let her know about our schedule change, she was clearly very busy and less than enthusiastic about our revised agenda. Her style on the phone was far from the warm Maura Lynch that I met fourth months earlier in Ghana. I attributed her less-than-inviting-tone to Maura’s shear busyness and tried not to take it personally. Shannon and I boarded another bus back to Uganda where I told her all I knew about Kitovu and Dr. Maura Lynch over the roar of the African road.

For over 70 years, Sisters from the Medical Missionaries of Mary have been committed cost-effective healing and development in some of the most desperate parts of the developing world. In 1951, the Sisters came to Kitovu Hospital and have since grown the hospital to well over 200 beds with an outpatient clinic and community-based HIV program. Dr. Maura Lynch, an Irish surgeon and Sister, started the fistula program in 1990 and has since grown it from nothing into one of the leading fistula treatment centers in the world treating over 250 of the regions worst cases every year. The hospital built a dedicated fistula ward in 2005 and these facilities attract leading surgeons from around the world to come and operate and train. Dr. Maura used to do roughly 8 surgeries a month until she permanently lost sight in one eye in the middle of a VVF (fistula) surgery. Now she serves more of an administrative function, coordinating the expatriate surgeons who come to work at one of the four training and treatment camps. I hoped and expected this to be one of the most productive and important legs of our journey and I was really excited to be there during the camp.

When we finally arrived into the dusty roadside bus stop in Masaka, dusk was falling and we were immediately accosted by the bodaboda drivers trying to grab our bags and takeus for a ride on the back of their motorcycles. For safety purposes, I am completely opposed to riding on the back of motorcycles in Africa, especially when carrying a big bag (it totally throws off the balance). After several calls to Maura, we threatened to take a bodaboda and ultimately convinced her to send a hospital pick-up to rescue us from the dusty roadside. When we finally saw her, Maura was nice enough, but she had no place for us to stay and sent us to a hotel. We went to a local hotel and spent our Fourth of July eating samosas and wondering if this leg of the trip could possibly deliver on earlier hopes. To top it all off, the ATM wasn’t working and we were very quickly running out of cash. Life was not good on America’s birthday and I was real grumpy about it.

The next morning we hopped in an expensive taxi and road over to Kitovu’s hill not sure of what we would find. Neither Shannon nor I was feeling particularly good about how the morning would turn out, especially when Maura was no where to be found. As we walked into the compound, Shannon wanted to go back and try to get cash as it was a Saturday and our last hope till Monday. I convinced her to stay but she was not particularly happy about it and sort of went off in a different direction. I went to find John Kelly, the fistula legend and my good friend who I hoped would somehow give us out mojo back. After changing into scrubs, I wandered into the operating theatre where I immediately saw John Kelly and managed to catch his light-up-the-room smile with my camera. There was an hectic energy in the room, but amidst the excitement and my confusion, John greeted me warmly and I knew would be fine in Kitovu. Shortly thereafter, Maura tugged on my sleeve saying she had a place for us to stay and was sorry she didn’t have more time to welcome us, but that she was very glad we were here. Maura also said we needed to move right away in order to avoid excess hotel charges and my smile beamed as I went to find Shannon.

I caught up with Shannon in the courtyard of the ward and excitedly attempted to tell her about the turn around. Shannon beat me to it when she said, “You are not gonna believe the stories I am hearing here. This place is fantastic!” I silently nodded in agreement as we hustled off to check out.